Simultaneous Open Reduction and Salter Innominate Osteotomy for Developmental Dysplasia of the Hip

Haidar, Rachid; Jones, R Spencer; Vergroesen, Diederik A.; Evans, Gwyn A.

doi:10.1302/0301-620x.78b3.0780471

Cited by 64 publications

(77 citation statements)

References 15 publications

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“…In the literature anterior open reduction has been used in isolation in this age group but has also been combined with pelvic osteotomy [7,14,22,28,30,32,40,44,46], proximal femoral osteotomy [28,31,38,46], or both in a single stage [3,10,11,26,31,39]. It is unclear which surgical procedure or combination of procedures is least likely to result in clinically relevant AVN (K&M Types II-IV or equivalent) and most likely to provide satisfactory radiological and clinical results (Severin I or II or equivalent and McKay excellent or good rating or equivalent, respectively), while minimizing the requirement for further surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

How Does Bony Surgery Affect Results of Anterior Open Reduction in Walking-age Children With Developmental Hip Dysplasia?

Kothari

Grammatopoulos

Hopewell

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Anterior open reduction is commonly used to treat hip subluxation or dislocation in developmental dysplasia of the hip (DDH) in walking-age children. Pelvic and/ or femoral osteotomy may be used in addition, but it is unclear how this affects avascular necrosis (AVN) risk and radiological and clinical results. Questions/purposes The purpose of this study was to review studies of walking-age patients treated either with an open reduction alone or combined with pelvic and/or femoral osteotomies and determine whether there is a difference between groups in the proportion of patients: (1) developing clinically relevant femoral head AVN (Kalamchi & MacEwen Types II to IV or equivalent); (2) achieving a satisfactory radiological result (Severin Grade I/II or equivalent); (3) achieving a satisfactory clinical result (McKay excellent or good rating or equivalent); and (4) requiring further nonsalvage surgery. Methods MEDLINE, Embase, the Cochrane Centre Register of Controlled Trials, and ClinicalTrials.gov were searched for studies of anterior open reduction for DDH in children aged 12 months to 6 years old. We assessed AVN, clinical and radiological results, and requirement for further procedures. The effect of failed conservative management, traction, age at operation, and followup duration was also assessed. Eighteen studies met the review eligibility criteria. Conclusions Open reduction with concomitant pelvic osteotomy is the most appropriate option to provide durable results with the lowest risk of AVN and best radiological and clinical results. There is no evidence that addition of a femoral osteotomy provides any additional benefit to the patient, although it may be necessary to achieve reduction. Level of Evidence Level III, therapeutic study.

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Section: Discussionmentioning

confidence: 99%

How Does Bony Surgery Affect Results of Anterior Open Reduction in Walking-age Children With Developmental Hip Dysplasia?

Kothari

Grammatopoulos

Hopewell

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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“…During the last 36 years, the anterior approach has been reported less frequently [1,10,17,18,20,23,25,30,31,47,58,70,71,73,79,80] than the medial approach [4, 6, 7, 11, 16, 21, 22, 33, 36, 37, 39, 40, 46, 48-50, 52-54, 60, 69, 77, 78, 85, 88], especially in younger children.…”

Section: Introductionmentioning

confidence: 99%

Developmental Dislocation of the Hip Successfully Treated by Preoperative Traction and Medial Open Reduction: A 22-year Mean Followup

Farsetti

Caterini

Potenza

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background During the last 35 years, the medial approach has been reported more frequently than the anterior approach for open reduction of developmental dislocation of the hip (DDH), however, few studies have followed children treated by medial open reduction to adulthood. Questions/purposes The purposes of our study were: (1) to assess the development of 71 completely dislocated hips after medial open reduction, the incidence of additional surgery and avascular necrosis during the followup period, and the long-term radiographic and functional results; and (2) to compare our results with those obtained by others who performed open reduction either by the medial or anterior approach. Patients and Methods We retrospectively evaluated, after the end of growth, 71 hips in 52 patients who underwent open reduction by the medial approach. The mean age of the patients was 16 months (range, 3-36 months). After surgery, the hips were immobilized in 100°flexion, 60°a bduction, and neutral rotation for an average of 6 months. All patients had staged clinical and radiographic followups until skeletal maturity. The length of followup averaged 22 years (range, 13-32 years). Results In all the surgically treated hips, the acetabular index normalized by the end of growth, the incidence of avascular necrosis was 18%, and additional surgery was required in 15% of our cases. At the last followup, 93% of the hips were classified as Severin Classes I or II and 7% as Class III; 76% of the hips had an excellent result, 17% had a good result, and 7% had a fair result according to the McKay scale as modified by Barrett and colleagues. Conclusions Open reduction of DDH through a medial approach provided good long-term radiographic and functional results in patients 3 to 36 months old and it was the only surgery performed in 85% of our cases. Future comparative studies are needed to confirm our results, especially in older children. Level of evidence Level IV, therapeutic study.

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“…Barrett had AVN as 6% [24]. Hajdarhad AVN as 8.1% [51]. In this study, AVN were 47 of 198 hips (23.7%) ( Table 7).…”

Section: Avarcular Necrosismentioning

confidence: 47%

Comparative Study Age at Time Operation between Younger and Older than 18 Months for Development Dysplasia of the Hip in Children

Hưng¹,

Duc²,

Hien³

2018

OALib

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Background: The Innominate osteotomy as an integral component of combined open reduction for the treatment of dysplasia developed of the hip in children. Materials and Methods: Between 2011 and 2015, 198 hips of 176 patients with developmental dislocation of the hip underwent 0 operation. The patients were divided into two Variant based on the age at the time of open reduction: 12 months -less than 18 months (Variant 1) and upper 18 -36 months (Variant 2). There were 120 hips in V 1 and 69 hips in V 2. Preoperative Patients didn't use skin or skeletal traction, or femoral osteotomies. All patients were Open reduction and iliac osteotomy according to Zigzag morphology combined Fibular Allograft. Dislocations were graded according to Tönnis system. The acetabular index was measured common procedure: Clinical evaluation of modified McKay criteria, and Roentgenographic evaluation of Severin. Results: There were 134 (76.1%) of the patients were girls and 42 (23.9%) were boys. Twenty two (12.5%) patients were affected bilaterally. The right hip was involved in 31 (17.6%), and the left hip in 123 cases (69.9%). Tönnis grade: Tönnis 3 in 46 (23.3%), Tönnis. 4 in 152 (76.7%). The patient was performed at a mean age of 21.5 months (12 to 36) and the mean age at latest follow-up was 72.1 months (58 to 115), and the mean time follow-up was 41 months (32 to 53 months).Overall favorable result 188 hips (94.9%) and unfavorable result 10 hips (5.1%). Roentgenogrphic results were Excellent 79.8%, Good 15.2%, Fair 3.5%, Poor 1.5%. There were Redislocation 14 (7.1%) and Avascular necrosis 47 (23.7%). Conclusion: This operation was of good safety and efficacy. Fibular allograft was strength and graft was not resorption, more stable and structurally sound interposition material which could be contoured to the shape of the osteotomy site. The Zizag octeotomy acetabuloplasty the same shape of the acetabulum by hinging the horizontal branch of the triradiate cartilage following an incomplete osteotomy. At latest results, both Variant were none different.

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Simultaneous Open Reduction and Salter Innominate Osteotomy for Developmental Dysplasia of the Hip

Cited by 64 publications

References 15 publications

How Does Bony Surgery Affect Results of Anterior Open Reduction in Walking-age Children With Developmental Hip Dysplasia?

How Does Bony Surgery Affect Results of Anterior Open Reduction in Walking-age Children With Developmental Hip Dysplasia?

Developmental Dislocation of the Hip Successfully Treated by Preoperative Traction and Medial Open Reduction: A 22-year Mean Followup

Comparative Study Age at Time Operation between Younger and Older than 18 Months for Development Dysplasia of the Hip in Children

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